CAMH’s SER - Science on the street, at home, in the community

Research scientists are often wrongly pictured as working in isolation, cloistered in laboratories; their work understood by only an esoteric few. Not so for scientists in CAMH’s Social, Epidemiological Research (SER) department, who take their work to the field to address health and social policy concerns -- not only in Ontario but across Canada and around the World.

They work ‘on the ground’ in communities both physical and virtual. They do innovative and integrative work that addresses immediate issues of health, to be sure. But SER scientists also provide vital basic epidemiological research – knowledge that is power for informing prevention strategies, evaluating programs and developing health services in the real world.

“Their work is one of the key ways CAMH is realizing the scope and ambition of our Research Renaissance Project,” says Dr. Bruce Pollock, CAMH vice president, research.

Here’s a cross-section of just a few projects SER scientists are pursuing.

Dr. Samantha Wells

Taking it to the streets. SER science literally hits the road with the mobile lab in a multidisciplinary team project funded by the Canadian Institutes of Health Research and headed by Dr.Samantha Wells. Designed to gather a variety of data directly from community populations, the mobile lab is a specially equipped trailer that Dr. Wells says will bring research to communities, especially small, remote and disadvantaged ones that are all too often ignored by researchers. The mobile lab is funded under CAMH’s historic grant from the Canada Foundation for Innovation (CFI).

“We will gain important insights about how these communities tick and what factors contribute to mental health, substance use, violence problems and their burdens,” Dr. Wells says. “We will work closely with community partners to ensure that the findings are used to improve and develop locally tailored programs.”

Dr. Russell Callaghan

Dumpster diving for tobacco evidence. Dr. Russell Callaghan and his team have science in mind when they examine the refuse of dumpsters, sidewalks and gutters: how does gathering and sorting cigarette butts reveal the extent of contraband tobacco use? In an effort very close to home, the results were shocking. Fully 50% of the butts collected around CAMH were contraband and 40% of independent variety stores in the vicinity sold contraband cigarettes to Dr. Callaghan’s undercover assistants.

This work has important policy implications. When you look at pricing and taxing of legal tobacco products, the unintended consequence of increasing the price of legal tobacco seems to be to drive vulnerable users --such as adolescents and people with drug and mental health problems-- into the contraband market.

“These results point to the importance of considering the user culture before making broad social policy decisions,” Dr. Callaghan says.

Dr. Patricia Erickson

“These are kids who are hurting. They just want a break.” Few people willingly choose street life, and so-called ‘street kids’ are no exception. Dr Pat Erickson’s research has made unparalleled inroads into our understanding of a generally vulnerable, frightened and suspicious community of adolescents between 16 and 20 years-old. They’re a highly mobile group, wary of adults and difficult to treat with the mental health services many need. Pat’s work with this at-risk population shows that some can be reached –and trust can be built-- through a web-based storytelling project that presented poetry, personal narratives and other artwork by homeless youth who were mentored by Canadian writers.

Non-judgemental and supportive, Dr. Erickson’s project encouraged youth to describe their real or imagined world, in their own words. “All street kids started out as kids, at home and in school, but on their way to adulthood they got off track through no fault of their own,” she explains. “My work helps them find services they’ll accept which then improve their chances of success,” she goes on to say, “These are kids who are hurting. They just want a break. They have passion and creativity to be tapped – a spirit that needs to be fed.”

Dr. Erickson’s longstanding leadership in the addictions area as one of Canada’s first harm reductionists was also recently recognized by Ontario’s health minister.

Dr. Carolyn Dewa speaking at a Café Scientifique event, 2009

It’s the cost to the economy, stupid. Work and the workplace impact our quality of life, yet little is known about this complex relationship. In the hands of a social researcher like Dr. Carolyn Dewa, statistics become a powerful tool for revealing the economic toll of mental health problems, particularly in the workplace, and in combating the stigma too frequently associated with them.

By tracking the real costs to government and employers of mental illness in the workplace, Dr. Dewa’s widespread work in this area provides a powerful argument to advocates for the recognition of mental health as a fundamental part of Canada’s economic prosperity.

A recent pioneering study led by Dr. Dewa calculated the actual cost of mental health leave and found that on average it’s double the cost of a leave for a physical illness – her team estimates the cost to a company for a single employee on a short-term leave due to mental illness totals nearly $18,000. That’s a strong case for investing in preventative measures.

“[W]hile it is important to support workers that are on disability leave, it is crucial that businesses make mental health and wellness a priority to prevent disability in the first place,” says Dr. Dewa. Watch a video here of Dr. Dewa speaking about her work.

Dr. Laura Simich (with scientist Biljana Vasilevska)

Far from home. If home is where the hearth is, what happens to a person who must leave theirs thousands of miles behind? That’s a question that Dr. Laura Simich tries to answer with her research into the effects on the mental health of refugees of their flight to a new life in Canada. The meaning of home emerges from her data as a key concept linking social support, resettlement and mental health.

Dr. Simich points out the role her research findings play in assisting the successful integration of refugees into their new homes. “The qualities of home that refugees lack during their resettlement such as emotional support, valuable social roles and personal dignity highlight critical gaps that must be filled by mental health and other service providers to promote positive refugee mental health in their countries of resettlement,” she says.

One of Dr. Simich’s goals is to help alleviate the disconnect between the experience of refugees and service practice, and to improve the tools available to organizations that assist refugees. Ultimately, the goal is to improve the mental health of new Canadians.

Dr. John Cunningham

“Let’s take the treatment to the people.” Does problem drinking treatment need face-to-face interaction with a therapist to succeed? Not necessarily, according to Dr. John Cunningham. He’s developed a widely-used internet screening tool for self-diagnosis of problem drinking. The hook is a simple one. Over 80% of problem drinkers have access to the internet because they’re a group that’s largely made up of young adults who are comfortable using the web. Once they encounter the CheckYourDrinking.net site and apply its model to their own life, they reduce their alcohol consumption by 30%, a rate that compares favourably with face-to-face interventions.

Many problem drinkers don’t seek treatment because they fear the stigma attached to asking for help or because they think they can work out their problem on their own or simply because help isn’t available. The CheckYourDrinking.net online tool allows them to seek help in their own homes, or as Dr. Cunningham puts it: “If people won’t come to the treatment, let’s take the treatment to the people.”

These are only a few examples of the innovative and integrative research being undertaken by the scientists of the Social and Epidemiological Research Department. See also: